Translational research leader spearheads effort to change kidney function calculation to remove racial variables

NEWS FROM NEPHROLOGY

After a year of work to bring balance to an equation that measures kidney function by removing racial variables, Sharon Moe, MD, associate dean for clinical and translational medicine and director of the Division of Nephrology for Indiana University School of Medicine, is celebrating a nationally adopted change in how the glomerular filtration rate (GFR) is being calculated to improve patient lives.

The system-wide change for all patients over 18 years old was the result of collaborative work between Moe and other medical leaders in nephrology and Michelle Zimmerman, MD, of Indiana University Health. The calculation change went into effect March 30 for IU Health and goes into effect this month at Eskenazi Health.

A patient’s GFR describes the quantity filtered through the kidney and into urine. For the past 50 years, the flow rate has had various formulas to estimate it, and the most commonly used has a variable based on race.

“Race is a social construct and not a biologic factor and thus, should be included in the GFR estimating equation,” said Moe, who is also one of the co-directors of the Indiana Clinical and Translational Sciences Institute (CTSI). “This change now more accurately reflects the recommendations of national groups and substitutes the race variable with a numerical variable that was confirmed to reflect the gold standard measurement of GFR and does not include race.”

The estimated GFR equation refit was developed with a diverse population and has acceptable performance characteristics. Patients in the IU Health system who are being seen for kidney function issues may see their GFR change in their portal due to the newly adopted calculations. Clinicians may also see GFRs change, requiring medication dosing adjustments or changes in kidney staging decisions.

IU School of Medicine students also strongly advocated for this change.